Household Hand Hygiene in Indonesia: Public Health Determinants of Handwashing Facility Availability

Handwashing with soap is vital for preventing infectious diseases, yet data on household-level facilities in Indonesia remain limited. This study analyzed data from the 2020 Household Drinking Water Quality (HDWQ) survey, covering 15,721 households across 34 provinces, to determine the proportion of limited handwashing facilities among households with existing ones and the sociodemographic, environmental, and geographic factors related to their availability. Based on Joint Monitoring Programme (JMP) criteria, 37.1% of households had limited facilities, while 62.9% had basic facilities among households with existing infrastructure. Java-Bali and Eastern Indonesia had the lowest and the highest proportion of limited facilities (30.9% and 63.5%). Multivariable logistic regression with complex survey weighting showed that households in rural areas (AOR=1.95; 95% CI: 1.71-2.22), using unimproved water sources for hygiene (AOR=1.69; 95% CI: 1.37-2.09), unimproved sanitation (AOR=1.28, 95% CI: 1.05-1.55), or shared sanitation (AOR=2.00; 95% CI: 1.65-2.42) were more likely to have limited facilities. Despite national progress, regional disparities remain significant in access to handwashing facilities. Interventions should prioritize improving water and sanitation infrastructure in rural and Eastern Indonesia, while promoting household-level behavior change. These findings can inform national hygiene strategies in alignment with the Sustainable Development Goals.